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Table 3 Crude and adjusted ORs of severe COPD exacerbation associated with varying durations of current use of oral hypoglycemic agents

From: Use of antidiabetic medications and risk of chronic obstructive pulmonary disease exacerbation requiring hospitalization: a disease risk score-matched nested case–control study

 

Cases (n = 2700)

Controls (n = 9272)

OR (95% CI)

Crude OR

Model 1

Adjusted ORa

Model 2

Adjusted ORb

Current use, no (%)c

 Metformin

  ≤ 30 days

222 (8.2)

472 (5.1)

1.51 (1.26–1.82)d

1.55 (1.28–1.88)d

1.61 (1.32–1.96)d

  31–90 days

227 (8.4)

709 (7.7)

1.06 (0.89–1.26)

1.09 (0.91–1.31)

1.13 (0.94–1.37)

  91–180 days

148 (5.5)

736 (7.9)

0.66 (0.54–0.80)d

0.69 (0.56–0.85)d

0.72 (0.58–0.89)d

  181–365 days

167 (6.2)

964 (10.4)

0.54 (0.45–0.66)d

0.60 (0.50–0.73)d

0.63 (0.51–0.77)d

  > 365 days

341 (12.6)

1773 (19.1)

0.58 (0.50–0.67)d

0.65 (0.56–0.76)d

0.68 (0.57–0.79)d

 Non-metformin

741 (27.4)

2348 (25.3)

Reference

Reference

Reference

 p for trend

  

< 0.001

< 0.001

< 0.001

 Sulfonylureas

  ≤ 30 days

220 (8.2)

372 (4.0)

2.02 (1.67–2.45)d

2.24 (1.83–2.75)d

2.35 (1.90–2.89)d

  31–90 days

243 (9.0)

642 (6.9)

1.33 (1.11–1.59)d

1.46 (1.21–1.75)d

1.52 (1.26–1.85)d

  91–180 days

137 (5.1)

757 (8.2)

0.63 (0.51–0.77)d

0.68 (0.55–0.84)d

0.72 (0.58–0.90)d

  181–365 days

184 (6.8)

1023 (11.0)

0.60 (0.49–0.72)d

0.67 (0.55–0.81)d

0.70 (0.57–0.85)d

  > 365 days

397 (14.7)

1978 (21.3)

0.64 (0.55–0.74)d

0.73 (0.63–0.85)d

0.76 (0.65–0.90)d

 Non-sulfonylureas

665 (24.6)

2230 (24.1)

Reference

Reference

Reference

 p for trend

  

< 0.001

< 0.001

< 0.001

Current use, no (%)c

 α-Glucosidase inhibitors

  ≤ 30 days

42 (1.6)

135 (1.5)

1.14 (0.80–1.64)

1.12 (0.77–1.62)

1.12 (0.77–1.64)

  31–90 days

48 (1.8)

175 (1.9)

1.04 (0.75–1.45)

1.04 (0.74–1.46)

1.05 (0.74–1.48)

  91–180 days

26 (1.0)

120 (1.3)

0.80 (0.52–1.24)

0.77 (0.49–1.22)

0.78 (0.49–1.24)

  181–365 days

30 (1.1)

133 (1.4)

0.85 (0.56–1.27)

0.84 (0.55–1.29)

0.85 (0.55–1.31)

  > 365 days

53 (2.0)

211 (2.3)

0.94 (0.68–1.28)

1.02 (0.74–1.41)

1.03 (0.74–1.43)

 Non-α-glucosidase inhibitors

1647 (61.0)

228 (67.2)

Reference

Reference

Reference

 p for trend

  

0.525

0.810

0.835

 TZDs

  ≤ 30 days

31 (1.2)

74 (0.8)

1.63 (1.06–2.50)d

1.59 (1.02–2.49)d

1.59 (1.01–2.50)d

  31–90 days

26 (1.0)

79 (0.9)

1.26 (0.81–1.98)

1.31 (0.82–2.09)

1.33 (0.83–2.14)

  91–180 days

23 (0.9)

95 (1.0)

0.88 (0.55–1.41)

0.94 (0.58–1.54)

0.94 (0.57–1.55)

  181–365 days

16 (0.6)

138 (1.5)

0.44 (0.26–0.75)d

0.52 (0.30–0.89)d

0.52 (0.30–0.89)d

  > 365 days

27 (1.0)

180 (1.9)

0.53 (0.35–0.80)d

0.58 (0.37–0.89)d

0.57 (0.37–0.89)d

 Non-TZDs

1723 (63.8)

6436 (69.4)

Reference

Reference

Reference

 p for trend

  

0.004

0.050

0.039

Current use, no (%)c

 DPP-4 inhibitors

  ≤ 30 days

32 (1.2)

95 (1.0)

1.31 (0.86–2.02)

1.27 (0.81–1.99)

1.31 (0.83–2.08)

  31–90 days

44 (1.6)

128 (1.4)

1.29 (0.90–1.85)

1.26 (0.86–1.84)

1.30 (0.89–1.91)

  91–180 days

36 (1.3)

107 (1.2)

1.33 (0.90–1.97)

1.42 (0.95–2.12)

1.47 (0.97–2.21)

  181–365 days

28 (1.0)

127 (1.4)

0.83 (0.54–1.27)

0.82 (0.52–1.28)

0.85 (0.54–1.33)

  > 365 days

41 (1.5)

188 (2.0)

0.81 (0.57–1.16)

0.89 (0.61–1.29)

0.93 (0.64–1.35)

 Non-DPP-4 inhibitors

1665 (61.7)

6357 (68.6)

Reference

Reference

Reference

 p for trend

  

0.586

0.787

0.860

 Meglitinides

  ≤ 30 days

54 (2.0)

86 (0.9)

2.36 (1.66–3.37)d

2.01 (1.39–2.92)d

2.03 (1.40–2.95)d

  31–90 days

55 (2.0)

136 (1.5)

1.60 (1.16–2.21)

1.30 (0.92–1.83)

1.32 (0.93–1.88)

  91–180 days

37 (1.4)

121 (1.3)

1.18 (0.81–1.72)

0.81 (0.54–1.21)

0.81 (0.54–1.22)

  181–365 days

39 (1.4)

115 (1.2)

1.33 (0.91–1.93)

1.14 (0.77–1.70)

1.14 (0.77–1.69)

 > 365 days

56 (2.1)

193 (2.1)

1.15 (0.85–1.57)

1.01 (0.74–1.39)

1.02 (0.74–1.40)

 Non-meglitinides

1605 (59.4)

6351 (68.5)

Reference

Reference

Reference

 p for trend

  

0.015

0.615

0.588

  1. OR, odds ratio; COPD, chronic obstructive pulmonary disease; CI confidence interval; No., Number; TZD, thiazolidinedione; DPP-4, dipeptidyl peptidase-4; DM, diabetic mellitus
  2. a Adjusted for all covariates with standardized difference > 0.1 in Table 1
  3. b Adjusted for all covariates with standardized difference > 0.1 in Table 1 and DM therapy regimen in the 180 days prior to the index date
  4. c Current use was defined as the end date of the most recent prescription within the 30 days prior to the index date
  5. d p < 0.05
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Respiratory Research

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